Dural Flaps

  • Anthony J. Raimondi

Abstract

After the craniotomy has been performed, and before the dura is opened, one should tack the dura to the periosteum of the skull. Because of the remarkably high degree of vascularization of the skull and the relatively loose adherence between outer layer of the dura and inner table of the skull, it is essential to sew the outer layer of the dura to the periosteum along the craniotomy line before proceeding to open the dura in order to minimize risks of epidural hematoma formation (4–0 sutures suffice to perform this). It is not necessary to perforate the skull to anchor these sutures because the periosteum is strong enough to offer adequate purchase. However, one should place the dural needle through the periosteum along a line parallel to the cut edge of the periosteum (skull), not perpendicular to it, since this avoids fraying or tearing of the periosteum at the time the knot is tied. One need not sew the dura to the periosteum along the region of the anterior or posterior fontanels, across a cranial suture, or at the superior sagittal or transverse sinues, since at these points outer layer of dura, cranial suture, and periosteum are one continuous structure in the newborn and infant.

Keywords

Superior Sagittal Sinus Dural Opening Transverse Sinus Pineal Region Middle Meningeal Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    Raimondi AJ: Reflection of a laminar flap for exposure of the spinal canal in children. Clin Neurosurg 25: 504–11, 1978.PubMedGoogle Scholar
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    Raimondi AJ, Gutierrez FA: Reconstruction of the posterior vertebral arch and laminotomy for intraspinal surgery. In Ransohoff J (ed): Modern Technics in Surgery—Neurosurgery. Mount Kisco, NY, Futura, 1979, pp 10–11.Google Scholar
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    Raimondi AJ, Gutierrez FA, DiRocco C: Laminotomy and total reconstruction of the posterior spinal arch for spinal canal surgery in childhood. J Neurosurg 45: 555–60, 1976.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1987

Authors and Affiliations

  • Anthony J. Raimondi

There are no affiliations available

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